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Barnhart L, Balzer C, Criswell S. Prevalence of Helicobacter pylori in routine adult tonsillectomies. Biotech Histochem 2024; 99:348-356. [PMID: 39177030 DOI: 10.1080/10520295.2024.2389535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2024] Open
Abstract
Helicobacter pylori, a curved bacterial rod and causative agent of peptic ulcer and gastric adenocarcinoma, is found as an infectious agent in the stomach of over half of the global population. H. pylori has been identified in oral biofilms and its presence in adenotonsillar tissues has been suggested, with variations in testing methodology both proving and disproving its presence. The current study employed 119 formalin-fixed paraffin-embedded tonsillar tissues from an adult population (n=86) in a major metropolitan city with immunohistochemistry procedures using a monoclonal antibody to determine the incidence of H. pylori in the tonsils. H. pylori was identified in 72.1% of the patients and was associated with Actinomyces spp. in 92.0% of those cases. The high incidence of H. pylori in patients undergoing tonsillectomy suggests that H. pylori may be a contributing factor for tonsillitis and tonsillar hypertrophy. Furthermore, the reservoir for H. pylori in the tonsils may explain why some persons remain refractory to antibiotic treatment for gastric H. pylori.
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Affiliation(s)
- Leica Barnhart
- Diagnostic and Health Sciences, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Chloe Balzer
- Diagnostic and Health Sciences, The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Sheila Criswell
- Diagnostic and Health Sciences, The University of Tennessee Health Science Center, Memphis, TN, USA
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Thangaraj P, Sakthignanavel A, Kaliyamoorthy S, Thingujam S, Radhakrishnan V. Association of Helicobacter Pylori in Chronic Tonsillitis. Indian J Otolaryngol Head Neck Surg 2024; 76:3001-3006. [PMID: 39130323 PMCID: PMC11306699 DOI: 10.1007/s12070-024-04569-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 02/18/2024] [Indexed: 08/13/2024] Open
Abstract
The objective of the study was to detect the presence of Helicobacter pylori in adenotonsillar tissue and to assess the association between the presence of H pylori with Chronic Tonsillitis or Adenotonsillitis. This was a cross sectional study conducted among 60 patients diagnosed with chronic tonsillitis and adeno tonsillitis undergoing tonsillectomy or adeno tonsillectomy meeting the paradise criteria in a tertiary care hospital, Pondicherry. Rapid urease test was done in the intraoperative period immediately after the specimens were taken.The rapid urease test kit was observed for color change from yellow to pink within 4 h. The tissue was sent for histopathological examination for staining with H&E and Giemsa stain to detect the presence of helicobacter pylori. The mean age of the study participants was 15.75 ± 8.46 and majority of the study participants were females. (61.7%). 66.7% and 33.3% of the study participants had chronic tonsillitis and adeno tonsillitis respectively. Oral swab showed normal flora, yeast and methicillin resistant Staphylococcus aureus in 96.6%, 1.7% and 1.7% respectively. 1.7% (1),13.3% (8) and 20% (12) of the study participants showed positive in card test immediate, at 15 min and 1 h respectively. Giemsa stain showed that 11.7% was positive for H.pylori. Out of the 7 patients with positive Giemsa stain, 4 had chronic tonsillitis and 3 had adenotonsillitis. Colonisation of adenoids and tonsils by H. pylori is a novel forefront with contradictory results dependent on the precision of the detective techniques used and population studied. Further research may be warranted to establish the varied colonisation depending on the geographical locations.
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Affiliation(s)
- Priyanka Thangaraj
- Department of Otorhinolaryngology, Aarupadai Veedu Medical College and Hospital, Vinayaka Mission Research Foundation, Deemed to be University, Puducherry, India
| | - Arulmozhi Sakthignanavel
- Department of Otorhinolaryngology, Aarupadai Veedu Medical College and Hospital, Vinayaka Mission Research Foundation, Deemed to be University, Puducherry, India
| | - Siva Kaliyamoorthy
- Department of Pathology, Aarupadai Veedu Medical College and Hospital, Vinayaka Mission Research Foundation, Deemed to be University, Puducherry, India
| | - Sonee Thingujam
- Department of Otorhinolaryngology, Shija Academy of Health Sciences, Imphal West, Manipur India
| | - Vaishnav Radhakrishnan
- Department of Otorhinolaryngology, Annapoorna Medical College and Hospital, Salem, Tamil Nadu India
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Helicobacter pylori Colonization in Patients with Adenotonsillar Hypertrophy: Study on Prevalence and Clinical Characteristics of Colonized Patients and Possible Association with Complications. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2020. [DOI: 10.5812/pedinfect.97561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jelavic B, Petricevic J, Marijanović I, Bevanda M. Helicobacter pylori in Otorhinolaryngology: Cause or Bystander. Eurasian J Med 2019; 51:196-202. [PMID: 31258363 DOI: 10.5152/eurasianjmed.2018.18192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The bacteria Helicobacter pylori (H. pylori) have been identified in the extragastric tissues in the head and neck. The origin and pathogenicity of these bacteria in the head and neck are not known. Gastric reflux and nasal or oral routes are the possible modes of spread. In many sinonasal, pharyngeal, laryngeal, and middle ear disorders, laryngopharyngeal reflux has been identified as a contributing or causative factor. One possible mode by which laryngopharyngeal reflux may contribute is by seeding of the extragastric mucosa with H. pylori. The clinical significance of the discovery of H. pylori in extragastric tissues in the head and neck is unclear. There is no evidence of a pathologic or active role of H. pylori in otorhinolaryngological disorders. The suggestion that the sinonasal cavities and pharynx may serve as a reservoir for H. pylori and that reinfection of the stomach occurs after eradication therapy awaits further studies for confirmation. No connection was observed between H. pylori found in the stomach and H. pylori found in the head and neck. Also, these bacteria, found in the head and neck tissues, may be accidental or innocent bystanders that do not affect the pathways of otolaryngological and gastroduodenal diseases. This review examines the evidence for a possible relationship of H. pylori with otorhinolaryngological diseases.
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Affiliation(s)
- Boris Jelavic
- Department of Otorhinolaryngology, University Hospital Mostar, Mostar, Bosnia and Herzegovina.,School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Josko Petricevic
- Department of Pathology, Cytology and Forensic Medicine, University Hospital Mostar, Mostar, Bosnia and Herzegovina.,School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Inga Marijanović
- Department of Oncology, University Hospital Mostar, Mostar, Bosnia and Herzegovina.,School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Milenko Bevanda
- Department of Gastroenterology, University Hospital Mostar, Mostar, Bosnia and Herzegovina.,School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
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Bayindir T, Toplu Y, Otlu B, Yakupogullari Y, Yildirim O, Kalcioglu MT. Prevalence of the Helicobacter pylori in the tonsils and adenoids. Braz J Otorhinolaryngol 2015; 81:307-11. [PMID: 25900719 PMCID: PMC9452227 DOI: 10.1016/j.bjorl.2014.08.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 08/24/2014] [Indexed: 01/29/2023] Open
Abstract
Introduction There is an ongoing debate about the existence and effects of Helicobacter pylori (Hp) in adenotonsillar tissue. Objective A clinical study was conducted to assess the existence of Hp in the adenoid and/or adenotonsillar tissues, which were surgically excised due to chronic adenotonsillitis. Methods Phosphoglucosamine mutase gene for the detection of Hp and cytotoxin-associated gene as virulence gene were examined in 84 adenotonsillar tissues obtained from 64 patients and patients’ serum by using polymerase chain reaction. Results Hp IgG was detected in 57 (89%) patients’ serum. A total of seven tissue samples from 64 patients (10.9%) were found positive for Hp DNA, of which five were adenoids and two were tonsil tissues. All polymerase chain reaction positive samples were also positive for the cytotoxin-associated gene, which is a virulence determinant for the organism. Conclusion This study suggests that children are exposed to Hp at an early age of their life in this province. Hp may have a role in the pathogenesis of chronic adenotonsillitis, especially in endemic areas.
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Katra R, Kabelka Z, Jurovcik M, Hradsky O, Kraus J, Pavlik E, Nartova E, Lukes P, Astl J. Pilot study: Association between Helicobacter pylori in adenoid hyperplasia and reflux episodes detected by multiple intraluminal impedance in children. Int J Pediatr Otorhinolaryngol 2014; 78:1243-9. [PMID: 24865809 DOI: 10.1016/j.ijporl.2014.04.040] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2013] [Revised: 04/18/2014] [Accepted: 04/20/2014] [Indexed: 02/08/2023]
Abstract
OBJECTIVES The aim of this pilot study was to investigate an association between laryngopharyngeal reflux detected by combined multiple intraluminal impedance and pH monitoring and Helicobacter pylori in adenoid hyperplasia detected with real time polymerase chain reaction (PCR). METHODS The study group consisted of 30 children (median age 5.34 years) with extraesophageal symptoms of gastroesophageal reflux disease with adenoid hyperplasia. All children underwent adenoidectomy with subsequent PCR detection of H. pylori DNA in the tissue and multiple intraluminal impedance and pH monitoring. The most proximal impedance sensor was located 1cm caudal to the entrance of the oesophagus. RESULTS We found significant differences in the number of reflux episodes among patients with PCR positivity (median 35) and negativity (median 0) of H. pylori (p-value of Mann-Whitney U-test 0.0056). Patients with PCR positivity of H. pylori had significantly more reflux episodes reaching the upper oesophageal sphincter (p-value of Mann-Whitney U-test 0.023). The absence of reflux episode was the only independent factor for PCR negativity of H. pylori in the multiple logistic regression model. CONCLUSIONS These results support the hypothesis that reflux episodes reaching the upper oesophageal sphincter may play an important role in the transmission of H. pylori into lymphoid tissue of the nasopharynx and thus may contribute to adenoid hyperplasia in children.
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Affiliation(s)
- R Katra
- Department of ENT, 2nd Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic.
| | - Z Kabelka
- Department of ENT, 2nd Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic
| | - M Jurovcik
- Department of ENT, 2nd Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic
| | - O Hradsky
- Department of Paediatrics, 2nd Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic
| | - J Kraus
- Department of Otorhinolaryngology, Hospital Rudolph and Stephanie, Benešov, Czech Republic
| | - E Pavlik
- Department of Microbiology and Immunology and Institute of Medical Biochemistry and Laboratory Medicine, 1st Faculty of Medicine, General Faculty Hospital, Charles University, Prague, Czech Republic
| | - E Nartova
- Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic
| | - P Lukes
- Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic
| | - J Astl
- Department of ENT, 3rd Faculty of Medicine, Charles University, Military University Hospital, Prague, Czech Republic
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Yılmaz T, Bajin MD, Günaydın R&O, Özer S, Sözen T. Laryngopharyngeal reflux and Helicobacter pylori. World J Gastroenterol 2014; 20:8964-8970. [PMID: 25083069 PMCID: PMC4112879 DOI: 10.3748/wjg.v20.i27.8964] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Revised: 01/17/2014] [Accepted: 04/03/2014] [Indexed: 02/06/2023] Open
Abstract
Laryngopharyngeal reflux (LPR) occurs when gastric contents pass the upper esophageal sphincter, causing symptoms such as hoarseness, sore throat, coughing, excess throat mucus, and globus. The pattern of reflux is different in LPR and gastroesophageal reflux. LPR usually occurs during the daytime in the upright position whereas gastroesophageal reflux disease more often occurs in the supine position at night-time or during sleep. Ambulatory 24-h double pH-probe monitoring is the gold standard diagnostic tool for LPR. Acid suppression with proton pump inhibitor on a long-term basis is the mainstay of treatment. Helicobacter pylori (H. pylori) is found in many sites including laryngeal mucosa and interarytenoid region. In this paper, we aim to present the relationship between LPR and H. pylori and review the current literature.
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Kraus J, Nártová E, Pavlík E, Katra R, Sterzl I, Astl J. Prevalence of Helicobacter pylori in adenotonsillar hypertrophy in children. Acta Otolaryngol 2014; 134:88-92. [PMID: 24256044 DOI: 10.3109/00016489.2013.840924] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
CONCLUSION Our results encourage the notion that the pharynx could be an extragastric reservoir of Helicobacter pylori (HP). The study confirmed the presence of HP in adenotonsillar tissue in children. It could have importance in the pathophysiology of upper respiratory diseases. However, its precise role in these processes remains unclear and requires further studies. OBJECTIVE A prospective study was carried out to evaluate the presence of HP in tonsillar and adenoid tissue in children. The study focused on real-time PCR analyzing CagA and VacA genotypes of HP strains. METHODS A total of 37 consecutive pediatric patients with adenotonsillar hypertrophy indicated for surgery were observed in a prospective study. Adenoidectomy and/or tonsillectomy was performed in each patient; 49 specimens were taken, 32 from adenoids and 17 from tonsils. The presence of HP and its genotype were tested in all samples by real-time PCR analysis. RESULTS Of 49 samples analyzed, 48 were positive for the presence of HP (98%), so only 1 sample was negative. While the genotype VacAs1bm2 was definitely dominant in adenoid tissue, wider distribution was observed in tonsillar tissue. Cag(+) strains represented one-fifth of all samples (21%).
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Affiliation(s)
- Jaroslav Kraus
- Department of Otorhinolaryngology, Hospital of Rudolf & Stefanie Benešov
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Güçlü O, Akçalı A, Sahin EM, Tekin K, Barutçu O, Otkun MT, Dereköy FS. Relationship between Helicobacter pylori Adenotonsillar Colonization and Frequency of Adenotonsillitis in Children. Balkan Med J 2013; 30:301-4. [PMID: 25207124 DOI: 10.5152/balkanmedj.2013.8585] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2012] [Accepted: 04/12/2013] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND There are insufficient data in the literature on the presence of Helicobacter pylori in tonsil and adenoid tissue of patients with only airway obstruction. This study examined the presence of H. pylori in surgical cases with airway obstruction or recurrent infection. AIMS To investigate the relationship between H. pylori adenotonsillar colonisation and the frequency of adenotonsillitis and to compare paediatric and adult patients according to H. pylori tonsillar colonisation. STUDY DESIGN Prospective clinical trial. METHODS PATIENTS SCHEDULED FOR ADENOIDECTOMY OR TONSILLECTOMY WERE CLASSIFIED INTO THREE GROUPS BASED ON INDICATIONS: paediatric infection (n=29), paediatric obstruction (n=29) and adult infection (n=12). Tissue samples obtained from patients were examined for the presence of H. pylori by culture, rapid urease test and polymerase chain reaction. RESULTS Forty-nine tonsil tissues were examined. Positive results were found in two specimens with the rapid urease test (4.1%) and three with polymerase chain reaction examination (6.1%). Only three positive polymerase chain reaction results (5.8%) were identified in 52 adenoid tissue samples. There were no statistically significant differences in the presence of H. pylori between paediatric infection and obstruction groups or between paediatric infection and adult infection groups. CONCLUSION In our study, there was a low incidence of H. pylori colonisation in tonsil and adenoid tissues. Regarding H. pylori colonisation, there was no significant difference between paediatric infection and obstruction groups. Also, no significant difference was found between adult and paediatric cases.
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Affiliation(s)
- Oğuz Güçlü
- Department of Otolaryngology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Alper Akçalı
- Department of Medical Microbiology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Erkan Melih Sahin
- Department of Family Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Kazım Tekin
- Department of Otolaryngology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Ozan Barutçu
- Department of Otolaryngology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Müşerref Tatman Otkun
- Department of Medical Microbiology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Fevzi Sefa Dereköy
- Department of Otolaryngology, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
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Nártová E, Kraus J, Pavlík E, Lukeš P, Katra R, Plzák J, Kolářová L, Sterzl I, Betka J, Astl J. Presence of different genotypes of Helicobacter pylori in patients with chronic tonsillitis and sleep apnoea syndrome. Eur Arch Otorhinolaryngol 2013; 271:607-13. [PMID: 23864246 DOI: 10.1007/s00405-013-2607-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2013] [Accepted: 06/13/2013] [Indexed: 12/14/2022]
Abstract
Helicobacter pylori, a well-known gastric pathogen, has been detected in the oral cavity and oropharynx in tonsillar tissue. In our study, the presence of H. pylori in the tonsillar tissue of patients with chronic tonsillitis and sleep apnoea syndrome (SAS) was investigated. The aim was to detect and genotype H. pylori for a collection of data supporting the possible role of H. pylori in the aetiology of chronic tonsillitis and SAS. Helicobacter pylori was detected by real-time polymerase chain reaction (rt-PCR). 89 patients, 60 with a diagnosis of chronic tonsillitis and 29 with SAS, were tested. In the chronic tonsillitis group, Helicobacter was detected in 48 (80 %) specimens, cagA gene was detected in 12 samples (25 %) and 12 samples were negative. In SAS group, Helicobacter was found in 24 samples (82.76 %), cagA gene was detected in 5 (20.83 %) and 5 samples (17.24 %) were negative. Helicobacter pylori-specific immunoglobulins were tested by ELISA in the serum of 57 patients only with 41 (71.93 %) showing positive. Our results on H. pylori DNA detection and H. pylori seropositivity show 26.32 % discrepancy, slightly in favour of rt-PCR (15.79 % compared to 10.53 %). The H. pylori presence in tonsillar tissue does not depend on the type of oropharyngeal disease (p = 0.756). This study shows that oropharynx constitutes an extragastric reservoir of H. pylori infection which could serve as an aetiopathogenetic factor for chronic tonsillitis and tonsillar hyperplasia by SAS. No conclusion has yet been drawn about the mechanism of the process.
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Affiliation(s)
- Eva Nártová
- Department of Othorinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czech Republic,
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Does Helicobacter pylori Exist in Vocal Fold Pathologies and in the Interarytenoid Region? Dysphagia 2013; 28:382-7. [DOI: 10.1007/s00455-012-9444-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2012] [Accepted: 12/20/2012] [Indexed: 02/07/2023]
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The Role of Helicobacter pylori in Upper Respiratory System Infections: Is it More Than Colonization? Curr Infect Dis Rep 2012; 14:128-36. [PMID: 22311663 DOI: 10.1007/s11908-012-0237-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Helicobacter pylori (HP) is recognized as a common chronic human bacterial infection and is the most common cause of gastritis. Recent studies suggest an increased HP prevalence in patients with various extra-digestive inflammatory diseases. Since many respiratory diseases are characterized by chronic inflammation as well as increased immune response, and HP may enter the nasopharyngeal cavity by gastroesophageal reflux, an association between respiratory disorders and HP infection has been suggested. Several studies discover HP in clinical samples from the patients with upper respiratory system infections. Even some of them revealed a relief after the treatment directed to HP eradication. However some studies do not support this theory and whether this association means a definite proof of a causal relationship between HP and respiratory diseases needs to be clarified. In this study, we aimed to review the reports about the role of HP in upper respiratory system infections.
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Aydın E, Aydoğan F, Taştan E, Arslan N, Karaca G. Does helicobacter pylori have a role in the etiology of adenoid hypertrophy? Indian J Otolaryngol Head Neck Surg 2011; 66:65-70. [PMID: 24533361 DOI: 10.1007/s12070-011-0310-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Accepted: 09/05/2011] [Indexed: 01/04/2023] Open
Abstract
To investigate whether there is any association between nasopharyngeal reflux and adenoid hypertrophy in children by using 24-h pH monitoring with dual probe and to determine whether Helicobacter pylori simply colonises in adenoid tissue or it is present there temporarily due to extraesophageal reflux. A prospective study at a tertiary referral center. Thirty-two patients who underwent adenoidectomy, aged ranged between 4 and 13 were included. All children with adenoid hypertrophy underwent 24-h pH monitoring with a dual probe. Proximal probe was placed in the nasopharynx. The presence of nasopharyngeal reflux and gastroesophageal reflux were investigated by 24-h pH monitoring. The presence of H. pylori was investigated in adenoidectomy samples by HP-fast test. Of the 32 patients who underwent adenoidectomy, 5 had nasopharyngeal reflux positivity while 27 patients did not show nasopharyngeal reflux positivity with pH monitorisation. Helicobacter pylori could not be detected in 5 nasopharyngeal reflux positive children while 3 of 27 nasopharyngeal reflux negative children showed H. pylori positivity, one of them in the mucosa and others in the core. This study demonstrated the high incidence of nasopharyngeal reflux and gastroesophageal reflux in adenoid hypertrophy and the possible colonisation of H. pylori in the adenoid tissue. This may change the assesment of children with adenotonsillar hypertrophy in near future. However, more placebo controlled and double blind studies and larger series are still needed to support this hypothesis.
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Affiliation(s)
- Emine Aydın
- S.B. Ankara Eğitim ve Araştırma Hastanesi 2.KBB Kliniği Ulucanlar Caddesi Altındağ, Ankara, Turkey ; Department of Otolaryngology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Filiz Aydoğan
- Department of Otolaryngology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Eren Taştan
- Department of Otolaryngology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Necmi Arslan
- Department of Otolaryngology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Gökhan Karaca
- Department of General Surgery, Ankara Training and Research Hospital, Ankara, Turkey
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Abdel-Monem MH, Magdy EA, Nour YA, Harfoush RA, Ibreak A. Detection of Helicobacter pylori in adenotonsillar tissue of children with chronic adenotonsillitis using rapid urease test, PCR and blood serology: a prospective study. Int J Pediatr Otorhinolaryngol 2011; 75:568-72. [PMID: 21324534 DOI: 10.1016/j.ijporl.2011.01.021] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2010] [Revised: 01/14/2011] [Accepted: 01/18/2011] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Contradictory results have been reported regarding Helicobacter pylori (H. pylori) detection in adenotonsillar tissue. The aims of this study were to investigate whether adenotonsillar tissue of symptomatic children with chronic adenotonsillitis harbors the H. pylori organism, using two biopsy-based invasive methods namely; rapid urease test (RUT) and polymerase chain reaction (PCR) as well as blood serology and to compare the results obtained from each of these methods to the "gold standard". METHODS This prospective clinical study was carried out on 20 children aged between 2 and 10 years scheduled for tonsillectomy +/- adenoidectomy in a tertiary referral center. Exclusion criteria included: use of antacids, H(2) blockers or antibiotics during the previous month before surgery and adenotonsillectomy for obstructive sleep apnea. Core biopsy samples from resected adenotonsillar tissue was tested for H. pylori detection using both RUT and PCR assay for the ureC gene. Preoperative patient venous blood samples were also tested for H. pylori IgG antibodies. As a "gold standard", examined tissue was considered to be H. pylori infected if the two biopsy specimen-based methods (RUT and PCR) yielded positive results. RESULTS Thirty adenotonsillectomy specimens were tested (20 tonsils and 10 adenoids). RUT was positive in 16 (53.3%) specimens (12 tonsils and 4 adenoids). According to the "gold standard", 11/16 were considered false-positive, yielding this test sensitivity 100% and specificity 56%. The ureC gene sequence was detected by PCR in 5 (16.6%) specimens (3 tonsils and 2 adenoids), all of which were also positive by RUT, thus were considered H. pylori infected. Accordingly, PCR had a 100% sensitivity and specificity. Serology testing was positive for H. pylori IgG antibodies in 4/20 patients (20%), only two of them were found to have H. pylori infected adenotonsillar tissue. CONCLUSIONS Based on our findings it seems that adenotonsillar tissue may constitute an extra-gastric reservoir for H. pylori in symptomatic children with chronic adenotonsillitis. RUT was found to be of less accuracy than PCR in H. pylori detection in an extra-gastric location, thus results of previous studies using this test alone for detection of oral H. pylori should be treated with caution.
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Affiliation(s)
- Mohamed H Abdel-Monem
- Department of Otorhinolaryngology-Head & Neck Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Vilarinho S, Guimarães NM, Ferreira RM, Gomes B, Wen X, Vieira MJ, Carneiro F, Godinho T, Figueiredo C. Helicobacter pylori colonization of the adenotonsillar tissue: fact or fiction? Int J Pediatr Otorhinolaryngol 2010; 74:807-11. [PMID: 20452684 DOI: 10.1016/j.ijporl.2010.04.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Revised: 04/13/2010] [Accepted: 04/14/2010] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The transmission of the gastric pathogen Helicobacter pylori involves the oral route. Molecular techniques have allowed the detection of H. pylori DNA in samples of the oral cavity, although culture of H. pylori from these type of samples has been sporadic. Studies have tried to demonstrate the presence of H. pylori in adenotonsillar tissue, with contradictory results. Our aim was to clarify whether the adenotonsillar tissue may constitute an extra gastric reservoir for H. pylori. METHODS Sixty-two children proposed for adenoidectomy or tonsillectomy were enrolled. A total of 101 surgical specimens, 55 adenoid and 46 tonsils, were obtained. Patients were characterized for the presence of anti-H. pylori antibodies by serology. On each surgical sample rapid urease test, immunohistochemistry, fluorescence in situ hybridization (FISH) with a peptide nucleic acid probe for H. pylori, and polymerase chain reaction-DNA hybridization assay (PCR-DEIA) directed to the vacA gene of H. pylori were performed. RESULTS Thirty-nine percent of the individuals had anti-H. pylori antibodies. Rapid urease test was positive in samples of three patients, all with positive serology. Immunohistochemistry was positive in samples of two patients, all with negative serology. All rapid urease test or immunohistochemistry positive cases were negative by FISH. All samples tested were negative when PCR-DEIA for H. pylori detection was used directly in adenotonsillar specimens. CONCLUSIONS The adenotonsillar tissue does not constitute an extra gastric reservoir for H. pylori infection, at least a permanent one, in this population of children. Moreover, techniques currently used for detecting gastric H. pylori colonization are not adequate to evaluate infection of the adenotonsillar tissues.
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Affiliation(s)
- Sérgio Vilarinho
- Serviço de Otorrinolaringologia, Hospital de São Marcos, Braga, Portugal
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Vayisoglu Y, Ozcan C, Polat A, Delialioglu N, Gorur K. Does Helicobacter pylori play a role in the development of chronic adenotonsillitis? Int J Pediatr Otorhinolaryngol 2008; 72:1497-1501. [PMID: 18691771 DOI: 10.1016/j.ijporl.2008.06.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2008] [Revised: 06/25/2008] [Accepted: 06/26/2008] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Evaluation of the possible relationship between chronic adenotonsillitis and Helicobacter pylori (HP). PATIENTS AND METHODS The study was performed prospectively on 91 pediatric patients who underwent tonsillectomy, adenoidectomy or adenotonsillectomy due to chronic tonsillitis and/or adenoiditis. The adenotonsillectomy specimens were examined for HP colonization by rapid urease test (RUT) and immunohistochemical evaluation. Before surgery, anti-HP IgG and IgA antibody titers were detected by enzyme linked immunosorbent assay (ELISA) test in venous blood samples of the patients. RESULTS The RUT was positive in only two of the adenoidectomy specimens (2.2%) and in none of the tonsillectomy specimens. A positive result was not detected in any tonsillectomy specimens using immunohistochemical examination. Serum IgG antibody was positive in 21 (23%) patients, IgA antibody was detected in 7 (7.69%) patients and both tests were positive only in 3 (3.29%) patients. CONCLUSION The results of this study suggested that HP would not colonize in tonsil tissue of patients with chronic tonsillitis.
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Affiliation(s)
- Yusuf Vayisoglu
- Mersin University, School of Medicine, Department of Otorhinolaryngology, Mersin, Turkey.
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Goodman KJ, Joyce SL, Ismond KP. Extragastric diseases associated with Helicobacter pylori infection. Curr Gastroenterol Rep 2007; 8:458-64. [PMID: 17105683 DOI: 10.1007/s11894-006-0035-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This paper critically reviews the current literature on extragastric diseases associated with Helicobacter pylori infection, with an emphasis on methodologic issues that complicate interpretation of study findings. This review reveals common study limitations and overall uncertainty that H. pylori infection plays a role in extragastric diseases, although such a role has not been clearly ruled out for specific diseases of relevance. Evidence suggests that anti-H. pylori therapy may lead to improvement of a few extragastric diseases, in particular, idiopathic thrombocytopenic purpura, iron deficiency anemia, and chronic idiopathic urticaria, but the data from randomized controlled trials are insufficient to confirm this beneficial effect; if the benefit of anti-H. pylori therapy for specific diseases is real, it is not clear if it results from removing H. pylori-specific injurious effects, eliminating some other infectious pathogen, or reducing the total infectious burden.
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Affiliation(s)
- Karen J Goodman
- Division of Gastroenterology, Zeidler Ledcor Centre, University Campus 130, University of Alberta, Edmonton, AB, Canada, T6G 2X8.
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Pavlík E, Lukes P, Potuzníková B, Astl J, Hrdá P, Soucek A, Matucha P, Dosedĕl J, Sterzl I. Helicobacter pylori isolated from patients with tonsillar cancer or tonsillitis chronica could be of different genotype compared to isolates from gastrointestinal tract. Folia Microbiol (Praha) 2007; 52:91-4. [PMID: 17571803 DOI: 10.1007/bf02932145] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Helicobacter pylori from patients with different diseases, including so-called autoimmune thyroiditis, chronic tonsillitis and tonsillar cancer, was isolated and cultured. It was identified according to the genotype using labeled hybridization probes complementary to six sequences of cagA and vacA genes. Different types of strains were found in isolates from gastrointestinal tract and patients suffering from thyroiditis. Six out of seven genotyped isolates from patients in our Department of Otorhinolaryngology and Head and Neck Surgery exhibited the same genotype, differing from isolates obtained from other patients; the 7th isolate originated from a patient who had undergone surgery for deviatio septi nasi, at the same time suffering from autoimmune thyroiditis, having confirmed gastric infection by H. pylori from biopsy. This data made it possible to formulate the hypothesis on probable association of specific H. pylori genotype with chronic tonsillitis and tonsillar cancer. We assessed commercial transport media and improved nucleic acid isolation techniques and the RT-PCR-based tests, which allowed us to skip a culture step and to test directly the patients' samples; however, for full confirmation of our hypothesis and explanation of possible mechanisms of the contribution of Helicobacter sp. to the pathogenesis of the disease further data are to be collected and evaluated.
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Affiliation(s)
- E Pavlík
- Department of Immunology and Microbiology, 1st Faculty of Medicine, Charles University, Prague, Czechia.
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